About Matthew Ray Scott
About Matthew Ray Scott, Founder and CEO of FEED. The Agency:
Scott has been helping surgeons and medical device companies differentiate their brands for over a decade. FEED has won multiple awards, including Best Cause Marketing Agency for Healthcare Brands from the American Marketing Association.
Follow Matthew Ray Scott through his channels:
Communication Trumps Channel When Marketing Private Practices
We are agnostic about the channel. While we think that channel is important, what’s more important is communication. Are people literally and figuratively buying your story? We know how to create brand story that differentiates, that is inviting for people to come into your cause, your unique perspective.
Everyone Omar, I’m petite head of growth here at genom health and your host for another fantastic episode of journey to private practice. Our guest today, old friend of mine, good friend of mine from, uh, the world of LinkedIn, Matthew Ray, Scott, uh, who in my opinion, uh, is one of the best, uh, brand and marketing, uh, people out there when it comes to how does a physician.
Do marketing the right way, the effective way. Um, many of you known as the bearded brand, man. I know him as Matthew Ray, Scott, Matthew, thanks so much for joining us. How are you doing today? Uh, thank you, Omar. It’s been great. You know, as you mentioned, you and I connected on LinkedIn and you and I follow each other’s content, you and I give each other an attaboy, uh, whenever we have a piece of content that strikes a chord.
So thank you for having me. Oh, it’s my pleasure. Now, before we get into sort of the meat and potatoes of today’s talk around brand and marketing, you know, at a high level, can you tell us a little bit about your origin story and how you got to where you are today? Yeah, I think that to start my origin story, it’s important to understand that I went to one of the last all male military academy.
So I think. Juncture of my life. I was looking for a challenge. Um, my father was a career military officer, so I understood the dynamics of that. I knew how it would be formative. And so, um, went to a military academy. I had the opportunity to be commissioned as a second Lieutenant in the army and. My decisions, I think were one part based on having the right mentors step up alongside of me at the right time, young age, newly married, my wife and I were beginning the process of starting our family.
Um, I, in my particular situation, um, as a medical service Corps officer, as my first exposure, uh, certainly into combat and my first exposure in working with. Orthopedic surgeons and working with other surgeons. And it was my first glimpse into, you know, I really like the tempo and the calling that, that orthopedic surgeons have.
And in my case, I saw. Orthopedic surgeons running towards the sound of the gunfire and Iraq and, and, you know, and then having the opportunity when I came back, uh, to receive a master’s of healthcare management degree, compliments of uncle Sam and working in a hospital, working with those specialty surgeons.
And then I hit a critical juncture. I got selected for something called the psychological warfare program. Basically that program enabled me to have experience and an understanding of propaganda development, um, delving, and to help people make decisions. And. I, I stayed in the military till I was a captain.
And so combined with the medical combined with my master’s degree in healthcare management, and then this kind of quirky, psychological profiling warfare background. When it came time, I was a captain when it came time for me to consider, was I going to make it a career or not yet again, another mentor stepped up and said, Matthew, let me ask you a question.
Would you rather work for somebody? Or someday own your own organization that fills a niche. And I said the ladder and he said, well, then resist the temptation to go into consulting. Like all my other buddies, you know, who had the same master’s degree, et cetera were doing. And he said, go into medical sales and Omar, I just put my head down and I.
I want nothing to do with sales. I want nothing to do with medical sales turned out to be the best formative experience for me. And I tell people to this day, we’re all in sales, just, most people don’t realize it that led to the next chapter. Well briefly summarize this for you. I progressed in medical sales became a vice president, had worked for a company such as Medtronics Smith and nephew, new vase of big companies.
And then I had the opportunity to participate in a startup company and be a co-developer of a particular product that we took public. And we sold for 16 times earnings to Medtronic. Gave me a glimpse of looking at something from, like you said, Omar, the origin to creating a brand story to enlisting or inviting other people into our brand story, flipping it.
And then after that, it led to the formation of what I call my 15 degree to the left 15 degree to the right pivot of starting. Our healthcare brand agency feed, and we have office locations in Las Vegas, San Diego, and Northwest Arkansas. That’s fantastic. And I love that story and I’m happy you were able to share it.
So let’s talk about feed a little bit in terms of. You know, what, what, what is that that feed does? And I want to kind of, uh, also focuses podcasts for the physicians who are listening, you know? Cause I get that. I’m sure you get it all the time. I get it as well. The questions around like how do I do branding?
Right? How do I do marketing? Because as a physician you’re busy, especially surgeons, you’re, you’re super, super busy. And so while branding exercises are important, you also need marketing. That’s going to drive results, right? You need, you need patients into the door, you need, you needed to grow business.
So there has to be a balance there, but I’ll let you kind of take it, take it in any direction you want. Yeah. Let’s start from first with what is branding and what branding can mean practically for an orthopedic or a specialty surgeon that might be listening to us. So we say that branding for doctors is who you say you are, doctor who your patients say you are and who Google says you are.
So the most practical way that I know to define branding so that we get away from the astatic misspeak. The mutual mystification that sometimes surrounds itself around branding. And so doctors really gravitate towards that. With respect to our agency, we made a decision 13 years ago that we were going to become the specialist in our specialty.
And the way that we articulate that in our mission statement is we tell busy surgeons at feed, we help private practice specialty surgeons. Avoid the money pit, a traditional marketing and attract more ideal patients. And so what we’ve done is we’ve attached a blue collar. Lunch pail, get you not more patients, but rather more ideal patients, lower your patient acquisition cost and do it in a way that drives, thought leadership.
You can become the specialist in your specialty. And that’s how I explain it to surgeons, Omar. And it really helps because if you’re a surgeon listening to me, many of you you’ve been burned. By traditional marketing agencies, you’re spending too much money for too little results. And so we made a conscious decision while it’s true.
We understand marketing. We have a core competency in branding and too many surgeons listening to us today. You’re spending far too much money in trying to be found when you should be spending as little money as possible and being heard.
That’s that’s such a good way to put it. And, um, I, the audience can’t see, but I’m nodding my head so much because it’s not only applicable to surgeons and private practice applicable to any company company that I’m at right now. So, you know, where do you see most surgeons making a mistake? Because I feel like there’s a trend or a pattern here where they make mistakes somewhere and then that’s.
Nope, not going to do this marketing thing. I’ll, you know, let’s, let’s do things that make sense. Like let’s pay for like some Google ad words or something, you know? Yeah. I think that the overarching origin mistake that surgeons are making is you’re spending too much time and money telling patients what you do.
And therein lies the commodity language. Therein lies the conundrum of, is it any wonder why patients are confused and telling the difference between Dr. X and Dr. Y? So that’s origin mistake, number one, kind of a sub phylum, as long as we’re talking to people who pass organic chemistry and biology here, Omar, I know you got a little background and passing those courses.
The second pivot that I would say is. There’s not a patient in America. Who’s awakening this morning saying, I sure hope I can find a full service specialty surgeon that can do it all the specialist within the specialty is what patients are looking for. So your ability to think of yourself and I don’t mean just proceed.
Rather, I mean, we, we have what we call the six PS of brand positioning that in our, we have a complimentary brand RX audit. Imagine Omar in assessment, in assessment that says, doctor, we’re going to analyze and assess. We’re going to provide you with a history, diagnosis and prognosis on the health of your brand and reputation.
And we’ve offered this complementary brand audit to thousands of people. And here’s what we’ve learned. Oftentimes, surgeons, you don’t understand where you are and where you want to go with respect to aligning brand and marketing to specific goals. So we’re able to help you do that. We’re able to show you a stack ranking if you’re in the bay area.
If you’re in LA, if you’re in San Diego, you’re in Louisville, Kentucky. How interesting and helpful would it be for you to understand the health of your brand and your reputation in a way that shows you in comparison to other doctors? So those two areas, you know, patients are looking for the specialists within their specialty in terms of your unique perspective and the problems that you solve rather than what procedures you prefer.
Yeah, it makes so much sense too. I mean, we, uh, Jensen, we, you know, offer something similar, not from a marketing standpoint, but for us on the revenue and reimbursement side. But I think the first place you got to start is you have to know what you’re working with, you know, and not try and guess it gets it on your own.
Um, So, you know, outside of that, you know, with, let’s say, let’s say, uh, most recently, and this is, um, uh, this is specific to this person, a spine surgeon and orthopedic spine surgeon who is on, on his own, you know, uh, has a small staff and everything and trying to. You know, Brandon market himself to his, you know, to the cities in the city that he’s in is wedged.
Let’s say there’s two or three larger cities, like maybe 50 miles out from where he is. Right. So how does he focus on that catchment area? And should he focus at a high level marketing himself as a spine surgeon, or she go with a bread and butter procedure or procedure he wants to be known for and focus on developing the brand and content around it.
Yeah. Hey Omar. If you’ll allow me to literally take my right arm and reach over to this deck desk right next to me, I’m going to answer that question for your audience. Ready? Oh, please. Yeah, I’m ready. All right.
For those who are listening, he, Matthew has just disappeared and he’s back and I’m back. It’s it’s magic. I’m such a tiny dancer, Omar that I filled the screen. So here is it. Here is the answer. The answer is, is there are six PS. So if I’m speaking to this young spine surgeon or frankly at whatever age, and you come to me and you’re asking me the question of how should I position my brand?
Here it is Omar. These are, this is, we made this assessment. Because we receive on average 1.7 million patient feedback assessments in just orthopedics and spine from our, uh, artificial intelligence, patient review and reputation management software. So every month I sift through the data and here is what we’ve come up with patients.
In the center are looking for a specialist within the specialty, but notice that I don’t have the word procedure on it. Yeah. Have the things that lead you to a procedure. Exactly. So because no one, because no one goes on saying what’s the procedure they go on and look at things that they’re. Yeah. And please continue at the end.
Re yeah. I’m, I’m loving what I’m looking at. It. Yeah, so you and I would turn to that spine surgeon saying, stop talking about a laminectomy. No patient is waking up going. I need to start sifting through laminectomy procedures in the surrounding area. So the first P and I’ll be brief, the first P is pain.
And I don’t mean just physical pain in the patient. Your ability to connect with patients, intrinsically extrinsically, philosophically fractured healthcare market. Be a trusted guide in their pain. The next is perspective. I tell surgeons this all the time to that spine surgeon, who’s listening to us, your unique point of view.
It turns out that patients want to align themselves. With your unique perspective and point of view. Next is problem solving. Doctor, stop talking about pathology meets prognosis, and then prognosis meets procedure, and start talking about the problems that you’re committed to solve. Next is people P for physician P for people, the people in your team, those unique cast of characters in your practice who are committed to living, working, and playing in a community and outside that community in being a practitioner, the next word is process.
Omar process is the most profitable word that surgeons never knew that they should be using. We’ve tested this. If a doctor in your traditional marketing just simply says, step one, step two, step three. In our process to serve, you know, these particular patients. And then the last piece. Is place the place of treatment, be it a private practice, be it a hospital.
And that Omar is worth the value of this call, the six PS of positioning. And the reason why I share this strategy with you is because it’s the same Omar. I spend Monday through Friday talking to these spine surgeons. That you mentioned an orthopedic surgeons, and I tell them, I could ask you a bunch of open-ended questions and then you could start answering those.
Or I could tell you what we’ve learned in 13 years of branding and rebranding some of the top private practices around the world, not just in the us. And I can just tell you what we’ve come up with and then. In three minutes or less, you can tell me if you align with that or not. And that way we save each other a bunch of time and I find that they view it as respectful.
I’m not being pushy. I’m not trying to sell them anything. I’m just telling them just like they’ve got principles and habits to performing a lumbar fusion, minimally invasive endoscopically. We’ve done our homework and we’ve got six principles that are proven to position them as thought leaders spend less money on marketing to become that specialist within their specialty, in the mindset of their ideal patient.
Yeah. It makes so much sense. And it’s something I think, you know, I think analogies. People misused them because they try to use them to persuade and they don’t persuade, but they’re great at explaining things. And what you said makes complete sense because as a physician, you know, whether, you know, even my father, when you have a patient come in, you’re going to do a procedure.
There are some steps and there are requirements to be the patient, which is like, Hey, you’re going to follow my instruction as a physician. What you’re going to do before the surgery, what you’re going to do after the surgery. All these things. And you know, if you’re doing a lumbar fusion, a patient, patient’s like, no, actually look, doc, as soon as this is done, like I’m really strong.
Um, I wanna, I want to go and do like these activities, like at a week, I want to go on this vacation. It’s like, no, that I’m not doing that. That’s a risk. Like we’re not, we’re going to be, we’re going to fail. And I think a lot of physicians don’t realize that they deal with. Brandon marketers. And I think most, most marketing people, whether they’re in healthcare or not, you know, do get, you know, close to what you just said.
Right. But they don’t explain a position at the right way. And then the physicians kind of deciding, well, we’re going to do this marketing activity and we’re going to do that. And it’s like, well, you wouldn’t let your patient that’s right. Decide what activities they’re going to do and not do based on your procedure.
Why are you doing this with marketing? Which you know nothing about, yeah, this is not the pick and choose game. That’s right. Let’s take, let’s take a situation that every surgeon listening to us can relate to a patient walks into your office and they are holding the right.
As a doctor, you would never, ever diagnose and go, oh yeah, you know what? You need a knee replacement or, or you’ve got an appendicitis or you need to do this. That would be malpractice. So why should it be any different with respect to branding and marketing? Why should it be any different that we as marketers should not understand the Cardinal communication of every doctor?
Trusted oath with a patient, which is history, diagnosis, and prognosis. So what we do at our agency is we just take the communication skills that trusted doctors have every day, but they don’t understand how it relates to. You know, marketing to doctors, to be honest with you as a misunderstood word, um, I will tell you that doctors love traditional marketing and traditional ROI.
They love it. And the reason why they love it is because it goes something like this. I will pay you. I will trust you get me the results. And just the other day, Omar, I had a doc. Contact me was a spine surgeon, a noted spine surgeon, surgeon. I’m not breaking any confidence here by not telling you this person’s name.
And this person said, what’s the ROI of my brand. And I couldn’t resist Omar. I go, it’s like asking, what’s the ROI of your mother and Omar. There was a deafening pause and he started to laugh. And he said, I deserve that. Didn’t I? And I said, well, sir, I wouldn’t say you deserved it. But I would say that you earn the opportunity for me to give you an example and pivot you away from the way that you’ve been thinking in the past.
And he got it. And it makes complete sense because. You know, if that magical thing exists, right? You put money in and money comes out, guess what? Everybody’s going to do it. And at that point, right, you have no control over that. Right. I think, I think part of that is, you know, I, while I like a growth in digital marketing, but you know, I’m relying heavily, let’s say on Facebook or LinkedIn, right.
They make you pay for that audience. Right. And any day they get to decide, Hey, Price is higher and you’re going to reach fewer people, which has happened right. Happened to me. We were running LinkedIn ads, you know, was working well, first couple of weeks, then LinkedIn changed something and now not, I got to spend more money and I’m going to reach fewer people.
And so everything seems to keep mapping back to, you know, owning the narrative, going straight to the market. And I think providing enough context and content so that whatever story somebody has in their head, you provide a catalyst. That’s going to feed into that story to get them to that point of making that, that decision.
Otherwise you’re literally competing at the bottom of funnel with everybody else. And at that point, the decision’s already been made. You know, when somebody, you know, how, like, let me ask you this. I’ll answer first, how often do you go to buy a product or a service and you Google it and with that service or product in mind, for whatever reason that, that you have it in mind, and you decide in that path, you know what, I’m going to click on this, this shiny object, Google ad thing up here and go to that and say maybe for like chotsky items, but when it comes to like something expensive or a B2B service or.
You’re not doing that. Absolutely. You’re you’re not doing that. And, um, you know, doctor, if you’re listening to us, stop thinking like consumer marketing and start thinking patient marketing, let’s treat patients as they make decisions. Stop marketing, like the latest consumer trend out for us at feed Omar.
We are agnostic about the channel while we think that channel is important. What’s more important is communication. It’s are people literally and figuratively buying your stuff. And we know how to create brand story that differentiates that is inviting for people to come into your cause. Your unique perspective.
You know, there’s some story telling framework there that can lend itself to channels, but at ad feed, we stay focused on two different buckets, how patients make decisions and how busy surgeons make decisions. It’s it’s our focus area. And from that where the data points is the development of products and services that we offer in alignment with that decision making.
Yeah, and that makes complete sense and something, again, I’m leaving in the show notes for everybody to take advantage of the brand audit that, uh, that feed feed the agency provides. But, you know, for the certain listening where it has a good place to get started, I think part of it is going through the six P’s and maybe a checklist to say, well, how have we addressed this as a practice?
Way, shape or form. What, what type of medium, you know, uh, but a video blog or anything else, uh, channels will be done this through. Is that a good place to start or is there maybe, maybe there’s some somewhere better for a surgeon. Yeah for us, we have, you know, our model, our process for you. It’s one of our six P’s that we tell, uh, surgeons that can be, or should be a component of their brand positioning.
So for us P for process, our process is we will not work with you doctor period, unless you receive a complimentary brand RX. And the reason why is because we’re not here to resurrect the problems that you may have. Rather, we are here to offer a fresh complimentary assessment and audit on the health of your brand and your reputation.
And so we make that a requirement. Um, Omar. It’s telling that we have have surgeons that don’t want to receive that complimentary 20 page report, you know, 30 minute outbrief. And it’s telling it’s telling because they’ve been burned, they don’t have enough trust in us or other marketing agencies. And that’s fair.
On the flip side to that, it’s also telling. It’s telling with all due respect to a big enough segment of the market that private practice surgeons are comfortable with relinquishing the responsibility to an outside party. Hey, I want to take care of patients. You do this and every month I want a detailed report.
And what I say to doctors is you’re a brand manager. This is patients choosing you above and beyond. You got MD at the end of your name. And so the starting point for doctors with us at feed is don’t. You want to know where you’re at? Without being sold to, without being pitched to don’t. You want to know the health of your brand and marketing, and wouldn’t you be curious to know how you stack rank against the surgeons in your specialty, across the street?
So, you know, I tell people that’s the starting point. And then through that, typically what happens. Following the doctor patient model. Here’s your history, here’s your diagnosis. Here’s a prognosis. And in our case, Omar, and for doctors that are listening to this, please don’t take this out of context, but we will never follow up with you.
We’ll never stock. You will never give you an email that in the header line says, circling back, following up. Are you interested in working together? It’ll never happen. Why because our goal is to make that complimentary brand audit. So strategic, so valuable that it incites enough curiosity from you, the surgeon to go that’s helpful.
What do you recommend next? In accordance with your core competency. And then it allows us to earn that trust. That’s so missing from every other marketing agency or second cousin that has helped every doctor listening to us. Mate, there’s so much value in what you just said, and I kind of want to translate it in an interesting way, you know, and the SAS world, you know, We, we understand that from a B2B standpoint again, for, for those listening.
So SAS stands for software as a service. B2B stands for business business. When someone wants to talk to sales, they’ll talk to sales, but up until that point, you have to make sure. Everything, that person needs to educate themselves, whether it’s a video or a blog or comparison, it all exists. So they read it.
And there’s no curiosity for them to say, let me read a little bit more, let me check out this. Then they say, you know what? I want to talk to somebody. And I think it’s the same. It’s the same thing with in, in, in practice, like my bad. And so, and he wasn’t a marketing genius, but he had some, he got some things down, right from marketing, get a simple website, hit a few articles on there.
Uh, this is back in 20 2008, 2009. He did a video that showed him, treating patients with experiences, like more or less their process. Right. So there was enough there for patients to get information, to understand until they say, you know, I feel like I can trust this person. And I’m curious to like, learn about this whole process, including every Saturday, my dad would do a free, uh, varicose veins screening.
Come in, they’ll check you out. He’ll advise you everything. And it’s up to you whether you want to go to him or go somewhere else. And I think in that process, whether it’s both online or in person, you have to demonstrate expertise, trust in authorities. So somebody said. Yeah, I’m going to come to this person and I’m going to pay money to get taken care of by them, whether it’s a tech business marketing C or a physician, I think that’s the biggest thing.
And I think that physicians are expecting all of that literally to happen by magic or Goodwill of people, supposedly talking about them. And then somehow patients going to say, oh yeah, like, let me just go to this person. Yes. But we live in a different way. Right. I love how you phrase that and it’s, it’s so resonates with me.
Um, do you think it might be helpful if I kind of take that psychological warfare background and I can, in one statement, give you the psychological profiling of orthopedic and spine surgeons, would that you think that might be? I would love that a hundred percent. I’m I’m all about the PSYOPs. Let’s I let’s hear it.
Here it is. Um, so we created, we teach this in a course that we created for medical sales people who are struggling to engage with busy doctors and increased consultations. And the first module that we teach them as the psychological profile of specialty surgeons. And, and here it is, trust is your currency and their reputation as their bank account.
That’s the psychological profile assessment of specialty, sir. So there are doctors who will be listening to us and there’ll be tons of medical devices, leaders, you know, who have followed a path that you and I have Omar trust as their currency and their reputation as their bank account. So if you buy into my profiling premise, then the way that you and I communicate with busy surgeons, are we building trust?
And I submit to you that most medical device leaders be they sales, marketing, BizDev SAS are communicating to doctors in logical ways in transactional analysis ways instead of building trust. And so what you and I are talking about today is hopefully taking the alarm bell. And saying, if you communicate with busy healthcare providers and conversely doctor, if you’re communicating with patients, trust is our collective currency.
So is your spoken word or written word, your actions and your behaviors representative of that currency?
Yep. I have nothing to add to that. It’s it’s, it’s completely true. And I think, again, I think all of these things, it’s not just unique to physicians. I mean, look, even, even for business, you know, sales happens because of an exchange of trust. Right. And part of the reason why people may be struggling, let’s say with sales or marketing, everything, is that you haven’t built up enough trust.
Look, Matthew, I have, I I’m, I’ve been doing this for, for awhile. Not, not as long as you I’m, I’m, I’m following your, your, your footsteps. Um, um, Omar, here’s your beer then? You and I got locked out young, man. I know, man. I’m good. I’m getting, I’m getting there little by little, but, but look on LinkedIn. I was connected to thousands of marketers.
A lot of them, a lot of them do what you do in the sense that they they’re they’re in health care, branding and market. Why am I talking to you of all these people, right. And the reason why is because that currency you talk about, which is trust. You’ve been built, you know, building that currency with me indirectly for the last couple of years and that reputation of yours, that brand has been built passively for me, seeing, you know, you, you constantly give value, right?
For free giving advice to physicians, to marketers, you know, through LinkedIn and through these different channels. Right. Wastes for me to sort of learn more, right. You provided that, you know, uh, um, that, that trust and your reputation there and earning that sort of. Right. And I think when that happens, you know, when I thought, when I think of when someone says, I think this is actually, this is exactly, this is exactly how this conversation happened.
The surgeon I’m speaking about, he mentioned it and he said, well, are there any, is there any. Like people in brand and marketing that know surgeons. You’re the only person that came to my mind. And I actually went out on LinkedIn and I just checked on like, there’s actually a lot of people I know who do this.
Why is it Matthew? Ray, Scott, and fi came to mind only because of that trust and reputation. Yeah. You know, thank you for it. So, yeah. And, and again, like, I don’t know, maybe I’m a little old school, but as a marketer and this is not just for agency, this is just marketers and yeah. If you can’t brand and market yourself, well, how the hell are you going to do that for my own business?
Yeah. I tell people, you know, uh, I speak like you to Omar. I, I meet with, you know, medical device, marketing leaders and sales leaders, and I just go, Hey, they’re not, they’re literally and figuratively not buying your story. And, you know, and, and, and then we can kind of reverse engineer that unpack that. And, um, I personally think that there’s more innovation going on at the medical distributor level than is happening in the headquarters of fortune 500 medical device companies.
And the reason why, because COVID took distributor ships and it said we better pivot. We better evolve. And what I’m spending my time on is does taking distributorships who are innovation, but are acting like it’s 1999, praying for trade show, trade show boosts to continue. I take those people. We created a course called the medical sales RX, the virtual operating zoom, and we teach them this communication technique.
And we say to them, Don’t wait for manufacturer marketing to send you 17 pounds of literature or invite doctors to the 17th cervical fusion plate webinar. Don’t do it compliantly and creatively. Learn to communicate, increase consultations, decrease the amount of time that it takes for your ideal surgeons to know like trust and referrals.
And that’s exciting to me because most medical device companies truth be told where they’ve already got a lot of market share. They’re comfortable with safe Harbor holding on to what they have. But if you are David going up against Goliath and you’re listing Omar and I, now there’s never been a better opportunity to sling a stone and take down Goliath right now.
Completely agree. Completely agree, Matthew, I want to be mindful of your time. So I want to wrap things up and ready to do a little bit of a rapid fire questions. Um, you can take as long as you want to answer these, but the sooner you answered them faster, I’ll get to the next question. Um, and I’m going to, I’m going to kind of, uh, tailor this a little bit more just for the physicians who are listening.